Causes of intussusception in children

Written by Hu Qi Feng
Pediatrics
Updated on September 19, 2024
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The causes of intussusception are divided into primary and secondary types, with 95% being primary, commonly seen in infants and young children. In infants, the mesentery of the ileocecal area is not yet fully fixed and has greater mobility, which is a structural factor prone to intussusception. Secondary cases account for 5%, where intussusception occurs. Some intestines show clear organic changes, such as Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplication anomalies, abdominal purpura, and thickening of the intestinal wall, which can cause intussusception of the intestines. Certain triggers, including dietary changes, viral infections, and diarrhea, can induce intussusception.

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Intussusception should visit which department?

Intussusception generally falls under pediatric surgery, but many children arrive at the hospital without a clear self-diagnosis of intussusception; they often come due to abdominal pain. They can visit either the internal medicine department or the surgical department. At this point, the attending physician will conduct a thorough medical history inquiry, such as a standing abdominal radiograph, abdominal ultrasonography, and physical examination, to aid in diagnosis. If a diagnosis confirms the need for surgical intervention, whether it involves air enema or surgery, it is definitely within the scope of the surgical department.

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Written by Quan Xiang Mei
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Pediatric intussusception clinical manifestations

Intussusception often occurs in infants and young children. The symptoms of intussusception in infants and young children primarily include abdominal pain, crying, and vomiting as the main clinical manifestations. Frequent vomiting, abdominal distension, and abdominal pain are symptoms, with children exhibiting sudden abdominal distension, sudden abdominal pain, and sudden sharp screams. The most typical symptom of intussusception is the excretion of jelly-like stool, which resembles tomato sauce or jelly. These are common clinical presentations of intussusception in children. Some children who are less neurologically sensitive may only show symptoms of lethargy, mild vomiting, diarrhea, and the passing of jelly-like stool.

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Written by Hu Qi Feng
Pediatrics
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How to treat intussusception in infants

The treatment of intussusception mainly includes non-surgical and surgical methods. The non-surgical method involves enema treatment. Within 48 hours of the onset of intussusception, if the overall condition is good, there is no abdominal distension, no apparent dehydration, and no electrolyte disorders, ultrasound-guided hydrostatic enema, air enema, or barium enema can be performed. If the intussusception lasts more than 48 to 72 hours, or if the duration is shorter but the condition is severe, with intestinal necrosis or perforation, surgical treatment is required.

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Written by Hu Qi Feng
Pediatrics
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Can pediatric intussusception be cured?

Once intussusception occurs, only a small portion of the small intestinal intussusception can reduce on its own. Those occurring in the colon or where re-intussusception occurs generally cannot reduce spontaneously and require enema therapy or surgical treatment. Enema therapy refers to cases where the intussusception occurs within forty-eight hours, the overall condition is good, there is no abdominal distension, no obvious dehydration or electrolyte disorders, and air or barium enema can be used. If the condition persists for more than forty-eight hours, the overall condition is poor, with symptoms such as dehydration, lethargy, high fever, shock, significant abdominal distension, signs of peritoneal irritation, multiple occurrences of intussusception, prior organic changes, or situations requiring surgical treatment for small bowel intussusception.

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Written by Hu Qi Feng
Pediatrics
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Infant intussusception typical symptoms

The typical clinical manifestations of intussusception are as follows: Firstly, abdominal pain, which occurs in paroxysmal, regular episodes, characterized by sudden onset of severe colicky pain. The child appears restless and cries, with knees drawn to the abdomen, pale complexion, and relief coming after several minutes or longer; the pain reoccurs every ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive containing milk curds or food residues, later possibly containing bile, and in the late stage, fecal-like liquid may be vomited. Thirdly, bloody stools are a significant symptom, appearing within the first few hours; initially, stools may appear normal, later becoming scanty or absent. In about 85% of cases, a jam-like mucousy bloody stool is passed within six to twelve hours of onset, or bloody stools are found upon rectal examination. Fourthly, abdominal mass is often found in the right upper quadrant just below the ribs, where a slight movable intussusception mass can be palpated, resembling a sausage.